人体组织门在主动脉位置:重新操作和门反的决定因素
T P Willems1, J J Takkenberg, E W Steyerberg
1Department of Cardiothoracic Surgery, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
Circulation
|March 21, 2001
概括
大动脉置换的耐用性受患者年龄和植入技术的影响. 在年轻人中,更好的初始结果和降低重新手术风险,更喜欢根部置换而不是冠冕下植入.
科学领域:
- 心血管外科心血管外科
- 生物材料科学 生物材料科学
- 医疗成像医学成像
背景情况:
- 人体组织门用于大动脉门置换具有有限的耐用性.
- 耐用性受到多种相互关联的因素的影响.
- 了解这些决定因素对于改善患者的治疗结果至关重要.
研究的目的:
- 分析大动脉移植的耐用性决定因素.
- 评估这些决定因素与膜反之间的关系.
- 为了比较亚冠状动脉植入与根置换技术的结果.
主要方法:
- 使用等级线性建模分析了218个冷保存的大动脉全移植和81个肺自移植的数据.
- 连续回声心脏图,包括彩色多普勒,评估了大动脉反的严重程度 (喷射长度,喷射直径比).
- 随访时间平均为4.2年,检查了重新手术和吐进展的预测因素.
主要成果:
- 患者年龄,操作人员经验和全移植直径预测了重新手术.
- 冠心下植入显示出更多的初始大动脉吐,而不是根部置换.
- 年轻的接受者 (<40岁) 在中期随访时经历了更多的大动脉吐.
结论:
- 冠下植入具有学习曲线,导致更高的初始反和重新操作率.
- 大动脉 regurgitation 的进展是最小的,但在年轻人中加速,无论技术如何.
- 根部置换可能提供更好的初始结果和长期耐用性,特别是在年轻的患者中.
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